Essential Duties and Responsibilities include the following:
Load ("programs") executed managed care contracts into the contract management system
Update contracts with scheduled rate changes as of effective dates
Build new service definitions and implements new reimbursement methodology into the system as required
Consult with contract negotiators to recommend precise language and meaning of contracts to ensure that the contract
template accurately calculates the terms of the contract as negotiated
language, calculations and reimbursement of specific contracts using those codes
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Initiative to work independently
Proficient with telephone and email communications
Basic understanding of medical coding systems affecting the adjudication of patient accounts in EDI or UB04 form,
including: ICD-9, CPT, HCPCS, DRG, APG, APC, and revenue code structures
The analyst must have the ability to define problems collects data, establish facts, and draw valid conclusions. The analyst must have the ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.
To perform this job successfully, an individual should have:
symbolic representation and procedural logic
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
High School graduate or equivalent
Minimum of 1 (one) year of hospital revenue cycle experience or equivalent work experience
Excellent interpersonal skills required to communicate with direct staff and internal/external customers
Must possess excellent time management and organizational skills with great attention to detail
Maintain applicable continuing education requirements
The ability to work on multiple projects/initiatives at a time
Community Health System